• Author
    Rony Moon
  • Discovery PI

    Lindsay A. Brown, MD

  • Project Co-Author

    Lindsay A. Brown, MD, Nigel Wilkinson-Maitland, MD

  • Abstract Title

    A Pediatric Patient-Centered Anesthesia Preparation Children’s Book: Impact on Preoperative Anxiety in Children and Caregivers

  • Discovery AOC Petal or Dual Degree Program

    Healthcare Improvement & Health Equity Research

  • Abstract

    Background: 

    Pediatric preoperative anxiety is common and consistently associated with adverse perioperative outcomes, including difficult anesthesia induction and maladaptive postoperative behaviors. Existing educational resources are often not tailored to the pediatric anesthesia experience. These gaps highlight the need for accessible, developmentally appropriate, patient-centered tools to support perioperative preparation for children and caregivers. 

     

    Objective: 

    To evaluate a patient-centered children’s book as an intervention to reduce pediatric and caregiver preoperative anxiety.

     

    Methods: 

    This prospective pre and post interventional study enrolled children (aged five to nine years) undergoing elective procedures at the UCLA Health Outpatient Surgery Center and their caregivers. Participants were contacted 1-2 weeks preoperatively and asked to complete a survey prior to reading the provided study book. Anxiety level was rated using a child self-report scale (1(not worried) to 5 (extremely worried), presented as visual faces) and caregiver scale (1 (not anxious at all) to 10 (extremely anxious)). Post-intervention anxiety was assessed on the day of surgery, prior to the procedure. Paired t-tests were used to analyze changes in anxiety scores and thematic analysis identified common qualitative themes. 

     

    Results:

    Fourteen child-caregiver dyads were included. Mean pediatric anxiety score decreased from 3.21 to 2.21 (mean difference -1.00; p=0.007) and caregiver anxiety decreased from 4.79 to 3.21 (mean difference -1.57; p=0.002).

    Qualitative analysis showed 64% of children reported reassurance as the intervention helped reframe anesthesia as a safe “going to sleep” process, and 36% identified elements of choice (e.g., mask scent election) as comforting. Among caregivers, 70-80% reported improved understanding, increased confidence, and enhanced parent-child communication in preparing their child for the perioperative process.

     

    Conclusion:

    A patient-centered children’s book significantly reduced preoperative anxiety in both children and caregivers and represents a practical and scalable approach to perioperative preparation.

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